James S. Duncan

Jiyao Wang, Peiyu Duan, Nicha C. Dvornek et al.

Functional magnetic resonance imaging (fMRI) is a powerful tool for investigating human brain function. However, the high cost of data acquisition and the inherent subjectivity of psychiatric rating scales often lead to datasets with small sample sizes and variable label quality, especially when targeting a specific neurological condition. Combined with the inherently high dimensionality of fMRI data, these limitations substantially increase the risk of model overfitting. Recent years have seen growing interest in developing fMRI foundation models by combining multiple datasets; however, the computational resources needed for pretraining and fine-tuning are often prohibitive. We show that a lightweight self-supervised framework yields representations that generalize across diverse downstream tasks, outperforming fully supervised baselines and approaching the performance of large-scale models. We introduce BrainSimSiam, a data-efficient self-supervised representation learning framework that leverages positive-only data pairs to learn robust and generalizable features. We demonstrate that the learned representations achieve strong performance across multiple downstream classification and regression tasks, highlighting the potential of BrainSimSiam for data-limited neuroimaging applications.

Bo Zhou, Jo Schlemper, Neel Dey et al. · mit

While enabling accelerated acquisition and improved reconstruction accuracy, current deep MRI reconstruction networks are typically supervised, require fully sampled data, and are limited to Cartesian sampling patterns. These factors limit their practical adoption as fully-sampled MRI is prohibitively time-consuming to acquire clinically. Further, non-Cartesian sampling patterns are particularly desirable as they are more amenable to acceleration and show improved motion robustness. To this end, we present a fully self-supervised approach for accelerated non-Cartesian MRI reconstruction which leverages self-supervision in both k-space and image domains. In training, the undersampled data are split into disjoint k-space domain partitions. For the k-space self-supervision, we train a network to reconstruct the input undersampled data from both the disjoint partitions and from itself. For the image-level self-supervision, we enforce appearance consistency obtained from the original undersampled data and the two partitions. Experimental results on our simulated multi-coil non-Cartesian MRI dataset demonstrate that DDSS can generate high-quality reconstruction that approaches the accuracy of the fully supervised reconstruction, outperforming previous baseline methods. Finally, DDSS is shown to scale to highly challenging real-world clinical MRI reconstruction acquired on a portable low-field (0.064 T) MRI scanner with no data available for supervised training while demonstrating improved image quality as compared to traditional reconstruction, as determined by a radiologist study.

Chenyu You, Weicheng Dai, Fenglin Liu et al. · oxford

Recent studies on contrastive learning have achieved remarkable performance solely by leveraging few labels in the context of medical image segmentation. Existing methods mainly focus on instance discrimination and invariant mapping. However, they face three common pitfalls: (1) tailness: medical image data usually follows an implicit long-tail class distribution. Blindly leveraging all pixels in training hence can lead to the data imbalance issues, and cause deteriorated performance; (2) consistency: it remains unclear whether a segmentation model has learned meaningful and yet consistent anatomical features due to the intra-class variations between different anatomical features; and (3) diversity: the intra-slice correlations within the entire dataset have received significantly less attention. This motivates us to seek a principled approach for strategically making use of the dataset itself to discover similar yet distinct samples from different anatomical views. In this paper, we introduce a novel semi-supervised 2D medical image segmentation framework termed Mine yOur owN Anatomy (MONA), and make three contributions. First, prior work argues that every pixel equally matters to the model training; we observe empirically that this alone is unlikely to define meaningful anatomical features, mainly due to lacking the supervision signal. We show two simple solutions towards learning invariances - through the use of stronger data augmentations and nearest neighbors. Second, we construct a set of objectives that encourage the model to be capable of decomposing medical images into a collection of anatomical features in an unsupervised manner. Lastly, we both empirically and theoretically, demonstrate the efficacy of our MONA on three benchmark datasets with different labeled settings, achieving new state-of-the-art under different labeled semi-supervised settings.

Chenyu You, Weicheng Dai, Yifei Min et al.

Contrastive learning has shown great promise over annotation scarcity problems in the context of medical image segmentation. Existing approaches typically assume a balanced class distribution for both labeled and unlabeled medical images. However, medical image data in reality is commonly imbalanced (i.e., multi-class label imbalance), which naturally yields blurry contours and usually incorrectly labels rare objects. Moreover, it remains unclear whether all negative samples are equally negative. In this work, we present ACTION, an Anatomical-aware ConTrastive dIstillatiON framework, for semi-supervised medical image segmentation. Specifically, we first develop an iterative contrastive distillation algorithm by softly labeling the negatives rather than binary supervision between positive and negative pairs. We also capture more semantically similar features from the randomly chosen negative set compared to the positives to enforce the diversity of the sampled data. Second, we raise a more important question: Can we really handle imbalanced samples to yield better performance? Hence, the key innovation in ACTION is to learn global semantic relationship across the entire dataset and local anatomical features among the neighbouring pixels with minimal additional memory footprint. During the training, we introduce anatomical contrast by actively sampling a sparse set of hard negative pixels, which can generate smoother segmentation boundaries and more accurate predictions. Extensive experiments across two benchmark datasets and different unlabeled settings show that ACTION significantly outperforms the current state-of-the-art semi-supervised methods.

Chenyu You, Jinlin Xiang, Kun Su et al.

Many medical datasets have recently been created for medical image segmentation tasks, and it is natural to question whether we can use them to sequentially train a single model that (1) performs better on all these datasets, and (2) generalizes well and transfers better to the unknown target site domain. Prior works have achieved this goal by jointly training one model on multi-site datasets, which achieve competitive performance on average but such methods rely on the assumption about the availability of all training data, thus limiting its effectiveness in practical deployment. In this paper, we propose a novel multi-site segmentation framework called incremental-transfer learning (ITL), which learns a model from multi-site datasets in an end-to-end sequential fashion. Specifically, "incremental" refers to training sequentially constructed datasets, and "transfer" is achieved by leveraging useful information from the linear combination of embedding features on each dataset. In addition, we introduce our ITL framework, where we train the network including a site-agnostic encoder with pre-trained weights and at most two segmentation decoder heads. We also design a novel site-level incremental loss in order to generalize well on the target domain. Second, we show for the first time that leveraging our ITL training scheme is able to alleviate challenging catastrophic forgetting problems in incremental learning. We conduct experiments using five challenging benchmark datasets to validate the effectiveness of our incremental-transfer learning approach. Our approach makes minimal assumptions on computation resources and domain-specific expertise, and hence constitutes a strong starting point in multi-site medical image segmentation.

Chenyu You, Weicheng Dai, Yifei Min et al.

Medical data often exhibits long-tail distributions with heavy class imbalance, which naturally leads to difficulty in classifying the minority classes (i.e., boundary regions or rare objects). Recent work has significantly improved semi-supervised medical image segmentation in long-tailed scenarios by equipping them with unsupervised contrastive criteria. However, it remains unclear how well they will perform in the labeled portion of data where class distribution is also highly imbalanced. In this work, we present ACTION++, an improved contrastive learning framework with adaptive anatomical contrast for semi-supervised medical segmentation. Specifically, we propose an adaptive supervised contrastive loss, where we first compute the optimal locations of class centers uniformly distributed on the embedding space (i.e., off-line), and then perform online contrastive matching training by encouraging different class features to adaptively match these distinct and uniformly distributed class centers. Moreover, we argue that blindly adopting a constant temperature $τ$ in the contrastive loss on long-tailed medical data is not optimal, and propose to use a dynamic $τ$ via a simple cosine schedule to yield better separation between majority and minority classes. Empirically, we evaluate ACTION++ on ACDC and LA benchmarks and show that it achieves state-of-the-art across two semi-supervised settings. Theoretically, we analyze the performance of adaptive anatomical contrast and confirm its superiority in label efficiency.

Chenyu You, Weicheng Dai, Yifei Min et al.

Integrating high-level semantically correlated contents and low-level anatomical features is of central importance in medical image segmentation. Towards this end, recent deep learning-based medical segmentation methods have shown great promise in better modeling such information. However, convolution operators for medical segmentation typically operate on regular grids, which inherently blur the high-frequency regions, i.e., boundary regions. In this work, we propose MORSE, a generic implicit neural rendering framework designed at an anatomical level to assist learning in medical image segmentation. Our method is motivated by the fact that implicit neural representation has been shown to be more effective in fitting complex signals and solving computer graphics problems than discrete grid-based representation. The core of our approach is to formulate medical image segmentation as a rendering problem in an end-to-end manner. Specifically, we continuously align the coarse segmentation prediction with the ambiguous coordinate-based point representations and aggregate these features to adaptively refine the boundary region. To parallelly optimize multi-scale pixel-level features, we leverage the idea from Mixture-of-Expert (MoE) to design and train our MORSE with a stochastic gating mechanism. Our experiments demonstrate that MORSE can work well with different medical segmentation backbones, consistently achieving competitive performance improvements in both 2D and 3D supervised medical segmentation methods. We also theoretically analyze the superiority of MORSE.

Junlin Yang, Tian Yu, Nicha C. Dvornek et al.

Hepatocellular carcinoma (HCC) is biologically heterogeneous, shaped by the interplay between hepatic functional reserve and tumor-related oncologic factors; thus, similar survival outcomes may reflect fundamentally different underlying biological processes. Prognostic modeling in HCC is informed by rich multimodal information from multiparametric MRI and radiology reports from routine clinical practice. Existing prognostic vision-language models (VLMs) learn a single entangled latent representation that blends hepatic and tumor-related factors, limiting both accuracy and biological interpretability. We present BioFact-MoE, a biologically factorized Mixture of Experts (MoE) framework that explicitly decomposes liver and tumor factors via biologically supervised experts within a residual MoE survival architecture. On a HCC cohort of N=588 patients (pretrained on 4,582 3D MRI image-report pairs), BioFact-MoE consistently improves survival prediction over all baselines across time horizons, achieving 12-, 18-, and 24-month AUCs of 75.33%, 75.85%, and 73.96%. Beyond scalar risk prediction, gated expert weights enable phenotype-aware risk stratification. Pathway-informed gating uncovers clinically meaningful treatment-associated survival heterogeneity. In held-out validation, hepatic and tumor embeddings show selective associations with liver function and tumor burden markers, respectively (p<0.05), without supervision. The code is available at https://github.com/jy-639/BioFact-MoE.

Siyuan Dong, Gilbert Hangel, Eric Z. Chen et al.

Magnetic Resonance Spectroscopic Imaging (MRSI) is an essential tool for quantifying metabolites in the body, but the low spatial resolution limits its clinical applications. Deep learning-based super-resolution methods provided promising results for improving the spatial resolution of MRSI, but the super-resolved images are often blurry compared to the experimentally-acquired high-resolution images. Attempts have been made with the generative adversarial networks to improve the image visual quality. In this work, we consider another type of generative model, the flow-based model, of which the training is more stable and interpretable compared to the adversarial networks. Specifically, we propose a flow-based enhancer network to improve the visual quality of super-resolution MRSI. Different from previous flow-based models, our enhancer network incorporates anatomical information from additional image modalities (MRI) and uses a learnable base distribution. In addition, we impose a guide loss and a data-consistency loss to encourage the network to generate images with high visual quality while maintaining high fidelity. Experiments on a 1H-MRSI dataset acquired from 25 high-grade glioma patients indicate that our enhancer network outperforms the adversarial networks and the baseline flow-based methods. Our method also allows visual quality adjustment and uncertainty estimation.

Jiyao Wang, Nicha C. Dvornek, Lawrence H. Staib et al.

Insufficiency of training data is a persistent issue in medical image analysis, especially for task-based functional magnetic resonance images (fMRI) with spatio-temporal imaging data acquired using specific cognitive tasks. In this paper, we propose an approach for generating synthetic fMRI sequences that can then be used to create augmented training datasets in downstream learning tasks. To synthesize high-resolution task-specific fMRI, we adapt the $α$-GAN structure, leveraging advantages of both GAN and variational autoencoder models, and propose different alternatives in aggregating temporal information. The synthetic images are evaluated from multiple perspectives including visualizations and an autism spectrum disorder (ASD) classification task. The results show that the synthetic task-based fMRI can provide effective data augmentation in learning the ASD classification task.

Bo Zhou, Yingda Xia, Jiawen Yao et al.

Pancreatic cancer is one of the leading causes of cancer-related death. Accurate detection, segmentation, and differential diagnosis of the full taxonomy of pancreatic lesions, i.e., normal, seven major types of lesions, and other lesions, is critical to aid the clinical decision-making of patient management and treatment. However, existing works focus on segmentation and classification for very specific lesion types (PDAC) or groups. Moreover, none of the previous work considers using lesion prevalence-related non-imaging patient information to assist the differential diagnosis. To this end, we develop a meta-information-aware dual-path transformer and exploit the feasibility of classification and segmentation of the full taxonomy of pancreatic lesions. Specifically, the proposed method consists of a CNN-based segmentation path (S-path) and a transformer-based classification path (C-path). The S-path focuses on initial feature extraction by semantic segmentation using a UNet-based network. The C-path utilizes both the extracted features and meta-information for patient-level classification based on stacks of dual-path transformer blocks that enhance the modeling of global contextual information. A large-scale multi-phase CT dataset of 3,096 patients with pathology-confirmed pancreatic lesion class labels, voxel-wise manual annotations of lesions from radiologists, and patient meta-information, was collected for training and evaluations. Our results show that our method can enable accurate classification and segmentation of the full taxonomy of pancreatic lesions, approaching the accuracy of the radiologist's report and significantly outperforming previous baselines. Results also show that adding the common meta-information, i.e., gender and age, can boost the model's performance, thus demonstrating the importance of meta-information for aiding pancreatic disease diagnosis.

Bo Zhou, Yu-Jung Tsai, Jiazhen Zhang et al.

Patient motion during PET is inevitable. Its long acquisition time not only increases the motion and the associated artifacts but also the patient's discomfort, thus PET acceleration is desirable. However, accelerating PET acquisition will result in reconstructed images with low SNR, and the image quality will still be degraded by motion-induced artifacts. Most of the previous PET motion correction methods are motion type specific that require motion modeling, thus may fail when multiple types of motion present together. Also, those methods are customized for standard long acquisition and could not be directly applied to accelerated PET. To this end, modeling-free universal motion correction reconstruction for accelerated PET is still highly under-explored. In this work, we propose a novel deep learning-aided motion correction and reconstruction framework for accelerated PET, called Fast-MC-PET. Our framework consists of a universal motion correction (UMC) and a short-to-long acquisition reconstruction (SL-Reon) module. The UMC enables modeling-free motion correction by estimating quasi-continuous motion from ultra-short frame reconstructions and using this information for motion-compensated reconstruction. Then, the SL-Recon converts the accelerated UMC image with low counts to a high-quality image with high counts for our final reconstruction output. Our experimental results on human studies show that our Fast-MC-PET can enable 7-fold acceleration and use only 2 minutes acquisition to generate high-quality reconstruction images that outperform/match previous motion correction reconstruction methods using standard 15 minutes long acquisition data.

Nicha C. Dvornek, Catherine Sullivan, James S. Duncan et al.

The multifactorial etiology of autism spectrum disorder (ASD) suggests that its study would benefit greatly from multimodal approaches that combine data from widely varying platforms, e.g., neuroimaging, genetics, and clinical characterization. Prior neuroimaging-genetic analyses often apply naive feature concatenation approaches in data-driven work or use the findings from one modality to guide posthoc analysis of another, missing the opportunity to analyze the paired multimodal data in a truly unified approach. In this paper, we develop a more integrative model for combining genetic, demographic, and neuroimaging data. Inspired by the influence of genotype on phenotype, we propose using an attention-based approach where the genetic data guides attention to neuroimaging features of importance for model prediction. The genetic data is derived from copy number variation parameters, while the neuroimaging data is from functional magnetic resonance imaging. We evaluate the proposed approach on ASD classification and severity prediction tasks, using a sex-balanced dataset of 228 ASD and typically developing subjects in a 10-fold cross-validation framework. We demonstrate that our attention-based model combining genetic information, demographic data, and functional magnetic resonance imaging results in superior prediction performance compared to other multimodal approaches.

Bo Zhou, Huidong Xie, Qiong Liu et al.

Low-count PET is an efficient way to reduce radiation exposure and acquisition time, but the reconstructed images often suffer from low signal-to-noise ratio (SNR), thus affecting diagnosis and other downstream tasks. Recent advances in deep learning have shown great potential in improving low-count PET image quality, but acquiring a large, centralized, and diverse dataset from multiple institutions for training a robust model is difficult due to privacy and security concerns of patient data. Moreover, low-count PET data at different institutions may have different data distribution, thus requiring personalized models. While previous federated learning (FL) algorithms enable multi-institution collaborative training without the need of aggregating local data, addressing the large domain shift in the application of multi-institutional low-count PET denoising remains a challenge and is still highly under-explored. In this work, we propose FedFTN, a personalized federated learning strategy that addresses these challenges. FedFTN uses a local deep feature transformation network (FTN) to modulate the feature outputs of a globally shared denoising network, enabling personalized low-count PET denoising for each institution. During the federated learning process, only the denoising network's weights are communicated and aggregated, while the FTN remains at the local institutions for feature transformation. We evaluated our method using a large-scale dataset of multi-institutional low-count PET imaging data from three medical centers located across three continents, and showed that FedFTN provides high-quality low-count PET images, outperforming previous baseline FL reconstruction methods across all low-count levels at all three institutions.

Shanlin Sun, Kun Han, Chenyu You et al.

Image registration is an essential step in many medical image analysis tasks. Traditional methods for image registration are primarily optimization-driven, finding the optimal deformations that maximize the similarity between two images. Recent learning-based methods, trained to directly predict transformations between two images, run much faster, but suffer from performance deficiencies due to model generalization and the inefficiency in handling individual image specific deformations. Here we present a new neural net based image registration framework, called NIR (Neural Image Registration), which is based on optimization but utilizes deep neural nets to model deformations between image pairs. NIR represents the transformation between two images with a continuous function implemented via neural fields, receiving a 3D coordinate as input and outputting the corresponding deformation vector. NIR provides two ways of generating deformation field: directly output a displacement vector field for general deformable registration, or output a velocity vector field and integrate the velocity field to derive the deformation field for diffeomorphic image registration. The optimal registration is discovered by updating the parameters of the neural field via stochastic gradient descent. We describe several design choices that facilitate model optimization, including coordinate encoding, sinusoidal activation, coordinate sampling, and intensity sampling. Experiments on two 3D MR brain scan datasets demonstrate that NIR yields state-of-the-art performance in terms of both registration accuracy and regularity, while running significantly faster than traditional optimization-based methods.

Peiyu Duan, Jiyao Wang, Nicha C. Dvornek et al.

Task-based fMRI provides a direct readout of task-evoked neural dynamics, but it is expensive and difficult to acquire at scale, motivating rest-to-task synthesis from widely available resting-state fMRI (rsfMRI). We propose FM-fMRI, an event-conditioned flow-matching model that learns a continuous-time conditional vector field to generate task ROI time series from a subject's rsfMRI and the task event information. The formulation enables fast ODE-based sampling and flexible conditioning over heterogeneous event schedules. Rather than optimizing for pointwise reconstruction, we evaluated generated signals using complementary criteria that probe temporal and spectral structure, subject and group-level connectome consistency, and distributional alignment. On the public Human Connectome Project and internal BioPoint autism cohort, FM-fMRI achieves the strongest spectral and connectivity agreement and improved distribution-level matching over conditional diffusion, generative adversarial networks (GANs), and variational autoencoders (VAEs) baselines. Furthermore, we augment the BioPoint cohort by synthesizing task-fMRI ROI time series with our method, improving downstream autism classification and demonstrating practical utility in data-limited clinical settings. The code will be available on GitHub.

Siyuan Dong, Henk M. De Feyter, Monique A. Thomas et al.

Purpose: Common to most MRSI techniques, the spatial resolution and the minimal scan duration of Deuterium Metabolic Imaging (DMI) are limited by the achievable SNR. This work presents a deep learning method for sensitivity enhancement of DMI. Methods: A convolutional neural network (CNN) was designed to estimate the 2H-labeled metabolite concentrations from low SNR and distorted DMI FIDs. The CNN was trained with synthetic data that represent a range of SNR levels typically encountered in vivo. The estimation precision was further improved by fine-tuning the CNN with MRI-based edge-preserving regularization for each DMI dataset. The proposed processing method, PReserved Edge ConvolutIonal neural network for Sensitivity Enhanced DMI (PRECISE-DMI), was applied to simulation studies and in vivo experiments to evaluate the anticipated improvements in SNR and investigate the potential for inaccuracies. Results: PRECISE-DMI visually improved the metabolic maps of low SNR datasets, and quantitatively provided higher precision than the standard Fourier reconstruction. Processing of DMI data acquired in rat brain tumor models resulted in more precise determination of 2H-labeled lactate and glutamate + glutamine levels, at increased spatial resolution (from >8 to 2 $μ$L) or shortened scan time (from 32 to 4 min) compared to standard acquisitions. However, rigorous SD-bias analyses showed that overuse of the edge-preserving regularization can compromise the accuracy of the results. Conclusion: PRECISE-DMI allows a flexible trade-off between enhancing the sensitivity of DMI and minimizing the inaccuracies. With typical settings, the DMI sensitivity can be improved by 3-fold while retaining the capability to detect local signal variations.

Daniel H. Pak, Shubh Thaker, Kyle Baylous et al.

High-quality volumetric meshing from medical images is a key bottleneck for physics-based simulations in personalized medicine. For volumetric meshing of complex medical structures, recent studies have often utilized deep learning (DL)-based template deformation approaches to enable fast test-time generation with high spatial accuracy. However, these approaches still exhibit limitations, such as limited flexibility at high-curvature areas and unrealistic inter-part distances. In this study, we introduce a simple yet effective snap-and-tune strategy that sequentially applies DL and test-time optimization, which combines fast initial shape fitting with more detailed sample-specific mesh corrections. Our method provides significant improvements in both spatial accuracy and mesh quality, while being fully automated and requiring no additional training labels. Finally, we demonstrate the versatility and usefulness of our newly generated meshes via solid mechanics simulations in two different software platforms. Our code is available at https://github.com/danpak94/Deep-Cardiac-Volumetric-Mesh.

Zhuotong Cai, Tianyi Zeng, Jiazhen Zhang et al.

Head movement poses a significant challenge in brain positron emission tomography (PET) imaging, resulting in image artifacts and tracer uptake quantification inaccuracies. Effective head motion estimation and correction are crucial for precise quantitative image analysis and accurate diagnosis of neurological disorders. Hardware-based motion tracking (HMT) has limited applicability in real-world clinical practice. To overcome this limitation, we propose a deep-learning head motion correction approach with cross-attention (DL-HMC++) to predict rigid head motion from one-second 3D PET raw data. DL-HMC++ is trained in a supervised manner by leveraging existing dynamic PET scans with gold-standard motion measurements from external HMT. We evaluate DL-HMC++ on two PET scanners (HRRT and mCT) and four radiotracers (18F-FDG, 18F-FPEB, 11C-UCB-J, and 11C-LSN3172176) to demonstrate the effectiveness and generalization of the approach in large cohort PET studies. Quantitative and qualitative results demonstrate that DL-HMC++ consistently outperforms state-of-the-art data-driven motion estimation methods, producing motion-free images with clear delineation of brain structures and reduced motion artifacts that are indistinguishable from gold-standard HMT. Brain region of interest standard uptake value analysis exhibits average difference ratios between DL-HMC++ and gold-standard HMT to be 1.2 plus-minus 0.5% for HRRT and 0.5 plus-minus 0.2% for mCT. DL-HMC++ demonstrates the potential for data-driven PET head motion correction to remove the burden of HMT, making motion correction accessible to clinical populations beyond research settings. The code is available at https://github.com/maxxxxxxcai/DL-HMC-TMI.

Xiongchao Chen, Bo Zhou, Xueqi Guo et al.

Single-Photon Emission Computed Tomography (SPECT) is widely applied for the diagnosis of coronary artery diseases. Low-dose (LD) SPECT aims to minimize radiation exposure but leads to increased image noise. Limited-view (LV) SPECT, such as the latest GE MyoSPECT ES system, enables accelerated scanning and reduces hardware expenses but degrades reconstruction accuracy. Additionally, Computed Tomography (CT) is commonly used to derive attenuation maps ($μ$-maps) for attenuation correction (AC) of cardiac SPECT, but it will introduce additional radiation exposure and SPECT-CT misalignments. Although various methods have been developed to solely focus on LD denoising, LV reconstruction, or CT-free AC in SPECT, the solution for simultaneously addressing these tasks remains challenging and under-explored. Furthermore, it is essential to explore the potential of fusing cross-domain and cross-modality information across these interrelated tasks to further enhance the accuracy of each task. Thus, we propose a Dual-Domain Coarse-to-Fine Progressive Network (DuDoCFNet), a multi-task learning method for simultaneous LD denoising, LV reconstruction, and CT-free $μ$-map generation of cardiac SPECT. Paired dual-domain networks in DuDoCFNet are cascaded using a multi-layer fusion mechanism for cross-domain and cross-modality feature fusion. Two-stage progressive learning strategies are applied in both projection and image domains to achieve coarse-to-fine estimations of SPECT projections and CT-derived $μ$-maps. Our experiments demonstrate DuDoCFNet's superior accuracy in estimating projections, generating $μ$-maps, and AC reconstructions compared to existing single- or multi-task learning methods, under various iterations and LD levels. The source code of this work is available at https://github.com/XiongchaoChen/DuDoCFNet-MultiTask.

Juntang Zhuang, Yifan Ding, Tommy Tang et al.

We propose ACProp (Asynchronous-centering-Prop), an adaptive optimizer which combines centering of second momentum and asynchronous update (e.g. for $t$-th update, denominator uses information up to step $t-1$, while numerator uses gradient at $t$-th step). ACProp has both strong theoretical properties and empirical performance. With the example by Reddi et al. (2018), we show that asynchronous optimizers (e.g. AdaShift, ACProp) have weaker convergence condition than synchronous optimizers (e.g. Adam, RMSProp, AdaBelief); within asynchronous optimizers, we show that centering of second momentum further weakens the convergence condition. We demonstrate that ACProp has a convergence rate of $O(\frac{1}{\sqrt{T}})$ for the stochastic non-convex case, which matches the oracle rate and outperforms the $O(\frac{logT}{\sqrt{T}})$ rate of RMSProp and Adam. We validate ACProp in extensive empirical studies: ACProp outperforms both SGD and other adaptive optimizers in image classification with CNN, and outperforms well-tuned adaptive optimizers in the training of various GAN models, reinforcement learning and transformers. To sum up, ACProp has good theoretical properties including weak convergence condition and optimal convergence rate, and strong empirical performance including good generalization like SGD and training stability like Adam. We provide the implementation at https://github.com/juntang-zhuang/ACProp-Optimizer.

Bo Zhou, Zachary Augenfeld, Julius Chapiro et al.

Multimodal image registration has many applications in diagnostic medical imaging and image-guided interventions, such as Transcatheter Arterial Chemoembolization (TACE) of liver cancer guided by intraprocedural CBCT and pre-operative MR. The ability to register peri-procedurally acquired diagnostic images into the intraprocedural environment can potentially improve the intra-procedural tumor targeting, which will significantly improve therapeutic outcomes. However, the intra-procedural CBCT often suffers from suboptimal image quality due to lack of signal calibration for Hounsfield unit, limited FOV, and motion/metal artifacts. These non-ideal conditions make standard intensity-based multimodal registration methods infeasible to generate correct transformation across modalities. While registration based on anatomic structures, such as segmentation or landmarks, provides an efficient alternative, such anatomic structure information is not always available. One can train a deep learning-based anatomy extractor, but it requires large-scale manual annotations on specific modalities, which are often extremely time-consuming to obtain and require expert radiological readers. To tackle these issues, we leverage annotated datasets already existing in a source modality and propose an anatomy-preserving domain adaptation to segmentation network (APA2Seg-Net) for learning segmentation without target modality ground truth. The segmenters are then integrated into our anatomy-guided multimodal registration based on the robust point matching machine. Our experimental results on in-house TACE patient data demonstrated that our APA2Seg-Net can generate robust CBCT and MR liver segmentation, and the anatomy-guided registration framework with these segmenters can provide high-quality multimodal registrations. Our code is available at https://github.com/bbbbbbzhou/APA2Seg-Net.

Juntang Zhuang, Tommy Tang, Yifan Ding et al.

Most popular optimizers for deep learning can be broadly categorized as adaptive methods (e.g. Adam) and accelerated schemes (e.g. stochastic gradient descent (SGD) with momentum). For many models such as convolutional neural networks (CNNs), adaptive methods typically converge faster but generalize worse compared to SGD; for complex settings such as generative adversarial networks (GANs), adaptive methods are typically the default because of their stability.We propose AdaBelief to simultaneously achieve three goals: fast convergence as in adaptive methods, good generalization as in SGD, and training stability. The intuition for AdaBelief is to adapt the stepsize according to the "belief" in the current gradient direction. Viewing the exponential moving average (EMA) of the noisy gradient as the prediction of the gradient at the next time step, if the observed gradient greatly deviates from the prediction, we distrust the current observation and take a small step; if the observed gradient is close to the prediction, we trust it and take a large step. We validate AdaBelief in extensive experiments, showing that it outperforms other methods with fast convergence and high accuracy on image classification and language modeling. Specifically, on ImageNet, AdaBelief achieves comparable accuracy to SGD. Furthermore, in the training of a GAN on Cifar10, AdaBelief demonstrates high stability and improves the quality of generated samples compared to a well-tuned Adam optimizer. Code is available at https://github.com/juntang-zhuang/Adabelief-Optimizer

Juntang Zhuang, Nicha C. Dvornek, Xiaoxiao Li et al.

Deep neural networks are vulnerable to adversarial attacks and hard to interpret because of their black-box nature. The recently proposed invertible network is able to accurately reconstruct the inputs to a layer from its outputs, thus has the potential to unravel the black-box model. An invertible network classifier can be viewed as a two-stage model: (1) invertible transformation from input space to the feature space; (2) a linear classifier in the feature space. We can determine the decision boundary of a linear classifier in the feature space; since the transform is invertible, we can invert the decision boundary from the feature space to the input space. Furthermore, we propose to determine the projection of a data point onto the decision boundary, and define explanation as the difference between data and its projection. Finally, we propose to locally approximate a neural network with its first-order Taylor expansion, and define feature importance using a local linear model. We provide the implementation of our method: \url{https://github.com/juntang-zhuang/explain_invertible}.

Peiyu Duan, Xueqi Guo, Sepehr Farhand et al.

Accurate 3D brain MRI subtype classification benefits from both localized anatomical cues and long-range contextual reasoning. We present AGA3DNet, a report-grounded framework that incorporates brief anatomical phrases extracted from radiology reports as a soft anatomical prior channel and fuses it with a lightweight 3D CNN and multi-view xLSTM aggregation. Specifically, extracted anatomical phrases are mapped to atlas-defined regions and converted into smooth spatial priors using a signed-distance transform followed by Gaussian weighting, providing interpretable, anatomy-grounded guidance without requiring dense voxel annotations. We evaluate AGA3DNet on a retrospective institutional brain MRI cohort for abnormal subtype discrimination and compare against reproducible 3D classification baselines. AGA3DNet achieves improved overall balance across performance metrics and supports clinically interpretable localization through the prior channel. We discuss limitations related to single-cohort evaluation and the lack of large-scale public brain MRI datasets paired with radiology reports under broadly usable terms.

Chenyu You, Yifei Min, Weicheng Dai et al.

Fine-tuning pre-trained vision-language models, like CLIP, has yielded success on diverse downstream tasks. However, several pain points persist for this paradigm: (i) directly tuning entire pre-trained models becomes both time-intensive and computationally costly. Additionally, these tuned models tend to become highly specialized, limiting their practicality for real-world deployment; (ii) recent studies indicate that pre-trained vision-language classifiers may overly depend on spurious features -- patterns that correlate with the target in training data, but are not related to the true labeling function; and (iii) existing studies on mitigating the reliance on spurious features, largely based on the assumption that we can identify such features, does not provide definitive assurance for real-world applications. As a piloting study, this work focuses on exploring mitigating the reliance on spurious features for CLIP without using any group annotation. To this end, we systematically study the existence of spurious correlation on CLIP and CLIP+ERM. We first, following recent work on Deep Feature Reweighting (DFR), verify that last-layer retraining can greatly improve group robustness on pretrained CLIP. In view of them, we advocate a lightweight representation calibration method for fine-tuning CLIP, by first generating a calibration set using the pretrained CLIP, and then calibrating representations of samples within this set through contrastive learning, all without the need for group labels. Extensive experiments and in-depth visualizations on several benchmarks validate the effectiveness of our proposals, largely reducing reliance and significantly boosting the model generalization.

Siyuan Dong, Zhuotong Cai, Gilbert Hangel et al.

Magnetic Resonance Spectroscopic Imaging (MRSI) is a non-invasive imaging technique for studying metabolism and has become a crucial tool for understanding neurological diseases, cancers and diabetes. High spatial resolution MRSI is needed to characterize lesions, but in practice MRSI is acquired at low resolution due to time and sensitivity restrictions caused by the low metabolite concentrations. Therefore, there is an imperative need for a post-processing approach to generate high-resolution MRSI from low-resolution data that can be acquired fast and with high sensitivity. Deep learning-based super-resolution methods provided promising results for improving the spatial resolution of MRSI, but they still have limited capability to generate accurate and high-quality images. Recently, diffusion models have demonstrated superior learning capability than other generative models in various tasks, but sampling from diffusion models requires iterating through a large number of diffusion steps, which is time-consuming. This work introduces a Flow-based Truncated Denoising Diffusion Model (FTDDM) for super-resolution MRSI, which shortens the diffusion process by truncating the diffusion chain, and the truncated steps are estimated using a normalizing flow-based network. The network is conditioned on upscaling factors to enable multi-scale super-resolution. To train and evaluate the deep learning models, we developed a 1H-MRSI dataset acquired from 25 high-grade glioma patients. We demonstrate that FTDDM outperforms existing generative models while speeding up the sampling process by over 9-fold compared to the baseline diffusion model. Neuroradiologists' evaluations confirmed the clinical advantages of our method, which also supports uncertainty estimation and sharpness adjustment, extending its potential clinical applications.

Chenyu You, Haocheng Dai, Yifei Min et al.

Machine learning models often rely on simple spurious features -- patterns in training data that correlate with targets but are not causally related to them, like image backgrounds in foreground classification. This reliance typically leads to imbalanced test performance across minority and majority groups. In this work, we take a closer look at the fundamental cause of such imbalanced performance through the lens of memorization, which refers to the ability to predict accurately on atypical examples (minority groups) in the training set but failing in achieving the same accuracy in the testing set. This paper systematically shows the ubiquitous existence of spurious features in a small set of neurons within the network, providing the first-ever evidence that memorization may contribute to imbalanced group performance. Through three experimental sources of converging empirical evidence, we find the property of a small subset of neurons or channels in memorizing minority group information. Inspired by these findings, we hypothesize that spurious memorization, concentrated within a small subset of neurons, plays a key role in driving imbalanced group performance. To further substantiate this hypothesis, we show that eliminating these unnecessary spurious memorization patterns via a novel framework during training can significantly affect the model performance on minority groups. Our experimental results across various architectures and benchmarks offer new insights on how neural networks encode core and spurious knowledge, laying the groundwork for future research in demystifying robustness to spurious correlation.

Xiaoran Zhang, Eric Z. Chen, Lin Zhao et al.

We propose a novel approach that adapts hierarchical vision foundation models for real-time ultrasound image segmentation. Existing ultrasound segmentation methods often struggle with adaptability to new tasks, relying on costly manual annotations, while real-time approaches generally fail to match state-of-the-art performance. To overcome these limitations, we introduce an adaptive framework that leverages the vision foundation model Hiera to extract multi-scale features, interleaved with DINOv2 representations to enhance visual expressiveness. These enriched features are then decoded to produce precise and robust segmentation. We conduct extensive evaluations on six public datasets and one in-house dataset, covering both cardiac and thyroid ultrasound segmentation. Experiments show that our approach outperforms state-of-the-art methods across multiple datasets and excels with limited supervision, surpassing nnUNet by over 20\% on average in the 1\% and 10\% data settings. Our method achieves $\sim$77 FPS inference speed with TensorRT on a single GPU, enabling real-time clinical applications.

Daniel H. Pak, Minliang Liu, Theodore Kim et al.

Calcification has significant influence over cardiovascular diseases and interventions. Detailed characterization of calcification is thus desired for predictive modeling, but calcified heart meshes for physics-driven simulations are still often reconstructed using manual operations. This poses a major bottleneck for large-scale adoption of computational simulations for research or clinical use. To address this, we propose an end-to-end automated meshing algorithm that enables robust incorporation of patient-specific calcification onto a given heart mesh. The algorithm provides a substantial speed-up from several hours of manual meshing to $\sim$1 minute of automated computation, and it solves an important problem that cannot be addressed with recent template registration-based heart meshing techniques. We validated our final calcified heart meshes with extensive simulations, demonstrating our ability to accurately model patient-specific aortic stenosis and Transcatheter Aortic Valve Replacement. Our method may serve as an important tool for accelerating the development and usage of physics-driven simulations for cardiac digital twins.

Xiaoran Zhang, Byung-Woo Hong, Hyoungseob Park et al.

We propose a model-agnostic, progressive test-time energy adaptation approach for medical image segmentation. Maintaining model performance across diverse medical datasets is challenging, as distribution shifts arise from inconsistent imaging protocols and patient variations. Unlike domain adaptation methods that require multiple passes through target data - impractical in clinical settings - our approach adapts pretrained models progressively as they process test data. Our method leverages a shape energy model trained on source data, which assigns an energy score at the patch level to segmentation maps: low energy represents in-distribution (accurate) shapes, while high energy signals out-of-distribution (erroneous) predictions. By minimizing this energy score at test time, we refine the segmentation model to align with the target distribution. To validate the effectiveness and adaptability, we evaluated our framework on eight public MRI (bSSFP, T1- and T2-weighted) and X-ray datasets spanning cardiac, spinal cord, and lung segmentation. We consistently outperform baselines both quantitatively and qualitatively.

Younjoon Chung, Hyoungseob Park, Patrick Rim et al.

We propose a method for test-time adaptation of pretrained depth completion models. Depth completion models, trained on some ``source'' data, often predict erroneous outputs when transferred to ``target'' data captured in novel environmental conditions due to a covariate shift. The crux of our method lies in quantifying the likelihood of depth predictions belonging to the source data distribution. The challenge is in the lack of access to out-of-distribution (target) data prior to deployment. Hence, rather than making assumptions regarding the target distribution, we utilize adversarial perturbations as a mechanism to explore the data space. This enables us to train an energy model that scores local regions of depth predictions as in- or out-of-distribution. We update the parameters of pretrained depth completion models at test time to minimize energy, effectively aligning test-time predictions to those of the source distribution. We call our method ``Energy-based Test-time Adaptation'', or ETA for short. We evaluate our method across three indoor and three outdoor datasets, where ETA improve over the previous state-of-the-art method by an average of 6.94% for outdoors and 10.23% for indoors. Project Page: https://fuzzythecat.github.io/eta.

Nicholas Konz, Richard Osuala, Preeti Verma et al.

Determining whether two sets of images belong to the same or different distributions or domains is a crucial task in modern medical image analysis and deep learning; for example, to evaluate the output quality of image generative models. Currently, metrics used for this task either rely on the (potentially biased) choice of some downstream task, such as segmentation, or adopt task-independent perceptual metrics (e.g., Fréchet Inception Distance/FID) from natural imaging, which we show insufficiently capture anatomical features. To this end, we introduce a new perceptual metric tailored for medical images, FRD (Fréchet Radiomic Distance), which utilizes standardized, clinically meaningful, and interpretable image features. We show that FRD is superior to other image distribution metrics for a range of medical imaging applications, including out-of-domain (OOD) detection, the evaluation of image-to-image translation (by correlating more with downstream task performance as well as anatomical consistency and realism), and the evaluation of unconditional image generation. Moreover, FRD offers additional benefits such as stability and computational efficiency at low sample sizes, sensitivity to image corruptions and adversarial attacks, feature interpretability, and correlation with radiologist-perceived image quality. Additionally, we address key gaps in the literature by presenting an extensive framework for the multifaceted evaluation of image similarity metrics in medical imaging -- including the first large-scale comparative study of generative models for medical image translation -- and release an accessible codebase to facilitate future research. Our results are supported by thorough experiments spanning a variety of datasets, modalities, and downstream tasks, highlighting the broad potential of FRD for medical image analysis.

Anne-Marie Rickmann, Stephanie L. Thorn, Shawn S. Ahn et al.

Cardiac image segmentation is an important step in many cardiac image analysis and modeling tasks such as motion tracking or simulations of cardiac mechanics. While deep learning has greatly advanced segmentation in clinical settings, there is limited work on pre-clinical imaging, notably in porcine models, which are often used due to their anatomical and physiological similarity to humans. However, differences between species create a domain shift that complicates direct model transfer from human to pig data. Recently, foundation models trained on large human datasets have shown promise for robust medical image segmentation; yet their applicability to porcine data remains largely unexplored. In this work, we investigate whether foundation models can generate sufficiently accurate pseudo-labels for pig cardiac CT and propose a simple self-training approach to iteratively refine these labels. Our method requires no manually annotated pig data, relying instead on iterative updates to improve segmentation quality. We demonstrate that this self-training process not only enhances segmentation accuracy but also smooths out temporal inconsistencies across consecutive frames. Although our results are encouraging, there remains room for improvement, for example by incorporating more sophisticated self-training strategies and by exploring additional foundation models and other cardiac imaging technologies.

Jiyao Wang, Nicha C. Dvornek, Peiyu Duan et al.

Functional MRI measuring BOLD signal is an increasingly important imaging modality in studying brain functions and neurological disorders. It can be acquired in either a resting-state or a task-based paradigm. Compared to resting-state fMRI, task-based fMRI is acquired while the subject is performing a specific task designed to enhance study-related brain activities. Consequently, it generally has more informative task-dependent signals. However, due to the variety of task designs, it is much more difficult than in resting state to aggregate task-based fMRI acquired in different tasks to train a generalizable model. To resolve this complication, we propose a supervised task-aware network TA-GAT that jointly learns a general-purpose encoder and task-specific contextual information. The encoder-generated embedding and the learned contextual information are then combined as input to multiple modules for performing downstream tasks. We believe that the proposed task-aware architecture can plug-and-play in any neural network architecture to incorporate the prior knowledge of fMRI tasks into capturing functional brain patterns.

Caglar Ozturk, Daniel H. Pak, Luca Rosalia et al.

Aortic stenosis (AS) is the most common valvular heart disease in developed countries. High-fidelity preclinical models can improve AS management by enabling therapeutic innovation, early diagnosis, and tailored treatment planning. However, their use is currently limited by complex workflows necessitating lengthy expert-driven manual operations. Here, we propose an AI-powered computational framework for accelerated and democratized patient-specific modeling of AS hemodynamics from computed tomography. First, we demonstrate that our automated meshing algorithms can generate task-ready geometries for both computational and benchtop simulations with higher accuracy and 100 times faster than existing approaches. Then, we show that our approach can be integrated with fluid-structure interaction and soft robotics models to accurately recapitulate a broad spectrum of clinical hemodynamic measurements of diverse AS patients. The efficiency and reliability of these algorithms make them an ideal complementary tool for personalized high-fidelity modeling of AS biomechanics, hemodynamics, and treatment planning.

Jiyao Wang, Nicha C. Dvornek, Peiyu Duan et al.

In recent years, graph neural networks (GNNs) have been widely applied in the analysis of brain fMRI, yet defining the connectivity between ROIs remains a challenge in noisy fMRI data. Among all approaches, Functional Connectome (FC) is the most popular method. Computed by the correlation coefficients between ROI time series, FC is a powerful and computationally efficient way to estimate ROI connectivity. However, it is well known for neglecting structural connections and causality in ROI interactions. Also, FC becomes much more noisy in the short spatio-temporal sliding-window subsequences of fMRI. Effective Connectome (EC) is proposed as a directional alternative, but is difficult to accurately estimate. Furthermore, for optimal GNN performance, usually only a small percentage of the strongest connections are selected as sparse edges, resulting in oversimplification of complex brain connections. To tackle these challenges, we propose the Spatio-Temporal Node Attention Graph Neural Network (STNAGNN) as a data-driven alternative that combines sparse predefined FC with dense data-driven spatio-temporal connections, allowing for flexible and spatio-temporal learning of ROI interaction patterns.

Tianqi Chen, Jun Hou, Yinchi Zhou et al.

Positron Emission Tomography (PET) is an important clinical imaging tool but inevitably introduces radiation hazards to patients and healthcare providers. Reducing the tracer injection dose and eliminating the CT acquisition for attenuation correction can reduce the overall radiation dose, but often results in PET with high noise and bias. Thus, it is desirable to develop 3D methods to translate the non-attenuation-corrected low-dose PET (NAC-LDPET) into attenuation-corrected standard-dose PET (AC-SDPET). Recently, diffusion models have emerged as a new state-of-the-art deep learning method for image-to-image translation, better than traditional CNN-based methods. However, due to the high computation cost and memory burden, it is largely limited to 2D applications. To address these challenges, we developed a novel 2.5D Multi-view Averaging Diffusion Model (MADM) for 3D image-to-image translation with application on NAC-LDPET to AC-SDPET translation. Specifically, MADM employs separate diffusion models for axial, coronal, and sagittal views, whose outputs are averaged in each sampling step to ensure the 3D generation quality from multiple views. To accelerate the 3D sampling process, we also proposed a strategy to use the CNN-based 3D generation as a prior for the diffusion model. Our experimental results on human patient studies suggested that MADM can generate high-quality 3D translation images, outperforming previous CNN-based and Diffusion-based baseline methods.

Yinchi Zhou, Tianqi Chen, Jun Hou et al.

Image-to-image translation is a vital component in medical imaging processing, with many uses in a wide range of imaging modalities and clinical scenarios. Previous methods include Generative Adversarial Networks (GANs) and Diffusion Models (DMs), which offer realism but suffer from instability and lack uncertainty estimation. Even though both GAN and DM methods have individually exhibited their capability in medical image translation tasks, the potential of combining a GAN and DM to further improve translation performance and to enable uncertainty estimation remains largely unexplored. In this work, we address these challenges by proposing a Cascade Multi-path Shortcut Diffusion Model (CMDM) for high-quality medical image translation and uncertainty estimation. To reduce the required number of iterations and ensure robust performance, our method first obtains a conditional GAN-generated prior image that will be used for the efficient reverse translation with a DM in the subsequent step. Additionally, a multi-path shortcut diffusion strategy is employed to refine translation results and estimate uncertainty. A cascaded pipeline further enhances translation quality, incorporating residual averaging between cascades. We collected three different medical image datasets with two sub-tasks for each dataset to test the generalizability of our approach. Our experimental results found that CMDM can produce high-quality translations comparable to state-of-the-art methods while providing reasonable uncertainty estimations that correlate well with the translation error.

Bo Zhou, Jun Hou, Tianqi Chen et al.

Low-dose PET offers a valuable means of minimizing radiation exposure in PET imaging. However, the prevalent practice of employing additional CT scans for generating attenuation maps (u-map) for PET attenuation correction significantly elevates radiation doses. To address this concern and further mitigate radiation exposure in low-dose PET exams, we propose POUR-Net - an innovative population-prior-aided over-under-representation network that aims for high-quality attenuation map generation from low-dose PET. First, POUR-Net incorporates an over-under-representation network (OUR-Net) to facilitate efficient feature extraction, encompassing both low-resolution abstracted and fine-detail features, for assisting deep generation on the full-resolution level. Second, complementing OUR-Net, a population prior generation machine (PPGM) utilizing a comprehensive CT-derived u-map dataset, provides additional prior information to aid OUR-Net generation. The integration of OUR-Net and PPGM within a cascade framework enables iterative refinement of $μ$-map generation, resulting in the production of high-quality $μ$-maps. Experimental results underscore the effectiveness of POUR-Net, showing it as a promising solution for accurate CT-free low-count PET attenuation correction, which also surpasses the performance of previous baseline methods.

Bo Zhou, Neel Dey, Jo Schlemper et al.

Multi-contrast MRI (MC-MRI) captures multiple complementary imaging modalities to aid in radiological decision-making. Given the need for lowering the time cost of multiple acquisitions, current deep accelerated MRI reconstruction networks focus on exploiting the redundancy between multiple contrasts. However, existing works are largely supervised with paired data and/or prohibitively expensive fully-sampled MRI sequences. Further, reconstruction networks typically rely on convolutional architectures which are limited in their capacity to model long-range interactions and may lead to suboptimal recovery of fine anatomical detail. To these ends, we present a dual-domain self-supervised transformer (DSFormer) for accelerated MC-MRI reconstruction. DSFormer develops a deep conditional cascade transformer (DCCT) consisting of several cascaded Swin transformer reconstruction networks (SwinRN) trained under two deep conditioning strategies to enable MC-MRI information sharing. We further present a dual-domain (image and k-space) self-supervised learning strategy for DCCT to alleviate the costs of acquiring fully sampled training data. DSFormer generates high-fidelity reconstructions which experimentally outperform current fully-supervised baselines. Moreover, we find that DSFormer achieves nearly the same performance when trained either with full supervision or with our proposed dual-domain self-supervision.

Chenyu You, Ruihan Zhao, Fenglin Liu et al.

Transformers have made remarkable progress towards modeling long-range dependencies within the medical image analysis domain. However, current transformer-based models suffer from several disadvantages: (1) existing methods fail to capture the important features of the images due to the naive tokenization scheme; (2) the models suffer from information loss because they only consider single-scale feature representations; and (3) the segmentation label maps generated by the models are not accurate enough without considering rich semantic contexts and anatomical textures. In this work, we present CASTformer, a novel type of adversarial transformers, for 2D medical image segmentation. First, we take advantage of the pyramid structure to construct multi-scale representations and handle multi-scale variations. We then design a novel class-aware transformer module to better learn the discriminative regions of objects with semantic structures. Lastly, we utilize an adversarial training strategy that boosts segmentation accuracy and correspondingly allows a transformer-based discriminator to capture high-level semantically correlated contents and low-level anatomical features. Our experiments demonstrate that CASTformer dramatically outperforms previous state-of-the-art transformer-based approaches on three benchmarks, obtaining 2.54%-5.88% absolute improvements in Dice over previous models. Further qualitative experiments provide a more detailed picture of the model's inner workings, shed light on the challenges in improved transparency, and demonstrate that transfer learning can greatly improve performance and reduce the size of medical image datasets in training, making CASTformer a strong starting point for downstream medical image analysis tasks.

Chenyu You, Yuan Zhou, Ruihan Zhao et al.

Automated segmentation in medical image analysis is a challenging task that requires a large amount of manually labeled data. However, most existing learning-based approaches usually suffer from limited manually annotated medical data, which poses a major practical problem for accurate and robust medical image segmentation. In addition, most existing semi-supervised approaches are usually not robust compared with the supervised counterparts, and also lack explicit modeling of geometric structure and semantic information, both of which limit the segmentation accuracy. In this work, we present SimCVD, a simple contrastive distillation framework that significantly advances state-of-the-art voxel-wise representation learning. We first describe an unsupervised training strategy, which takes two views of an input volume and predicts their signed distance maps of object boundaries in a contrastive objective, with only two independent dropout as mask. This simple approach works surprisingly well, performing on the same level as previous fully supervised methods with much less labeled data. We hypothesize that dropout can be viewed as a minimal form of data augmentation and makes the network robust to representation collapse. Then, we propose to perform structural distillation by distilling pair-wise similarities. We evaluate SimCVD on two popular datasets: the Left Atrial Segmentation Challenge (LA) and the NIH pancreas CT dataset. The results on the LA dataset demonstrate that, in two types of labeled ratios (i.e., 20% and 10%), SimCVD achieves an average Dice score of 90.85% and 89.03% respectively, a 0.91% and 2.22% improvement compared to previous best results. Our method can be trained in an end-to-end fashion, showing the promise of utilizing SimCVD as a general framework for downstream tasks, such as medical image synthesis, enhancement, and registration.

Bo Zhou, Rui Wang, Ming-Kai Chen et al.

Positron Emission Tomography (PET) is an important tool for studying Alzheimer's disease (AD). PET scans can be used as diagnostics tools, and to provide molecular characterization of patients with cognitive disorders. However, multiple tracers are needed to measure glucose metabolism (18F-FDG), synaptic vesicle protein (11C-UCB-J), and $β$-amyloid (11C-PiB). Administering multiple tracers to patient will lead to high radiation dose and cost. In addition, access to PET scans using new or less-available tracers with sophisticated production methods and short half-life isotopes may be very limited. Thus, it is desirable to develop an efficient multi-tracer PET synthesis model that can generate multi-tracer PET from single-tracer PET. Previous works on medical image synthesis focus on one-to-one fixed domain translations, and cannot simultaneously learn the feature from multi-tracer domains. Given 3 or more tracers, relying on previous methods will also create a heavy burden on the number of models to be trained. To tackle these issues, we propose a 3D unified anatomy-aware cyclic adversarial network (UCAN) for translating multi-tracer PET volumes with one unified generative model, where MR with anatomical information is incorporated. Evaluations on a multi-tracer PET dataset demonstrate the feasibility that our UCAN can generate high-quality multi-tracer PET volumes, with NMSE less than 15% for all PET tracers.

Bo Zhou, Chi Liu, James S. Duncan

A large amount of manual segmentation is typically required to train a robust segmentation network so that it can segment objects of interest in a new imaging modality. The manual efforts can be alleviated if the manual segmentation in one imaging modality (e.g., CT) can be utilized to train a segmentation network in another imaging modality (e.g., CBCT/MRI/PET). In this work, we developed an anatomy-constrained contrastive synthetic segmentation network (AccSeg-Net) to train a segmentation network for a target imaging modality without using its ground truth. Specifically, we proposed to use anatomy-constraint and patch contrastive learning to ensure the anatomy fidelity during the unsupervised adaptation, such that the segmentation network can be trained on the adapted image with correct anatomical structure/content. The training data for our AccSeg-Net consists of 1) imaging data paired with segmentation ground-truth in source modality, and 2) unpaired source and target modality imaging data. We demonstrated successful applications on CBCT, MRI, and PET imaging data, and showed superior segmentation performances as compared to previous methods.

Chenyu You, Ruihan Zhao, Lawrence Staib et al.

Contrastive learning (CL) aims to learn useful representation without relying on expert annotations in the context of medical image segmentation. Existing approaches mainly contrast a single positive vector (i.e., an augmentation of the same image) against a set of negatives within the entire remainder of the batch by simply mapping all input features into the same constant vector. Despite the impressive empirical performance, those methods have the following shortcomings: (1) it remains a formidable challenge to prevent the collapsing problems to trivial solutions; and (2) we argue that not all voxels within the same image are equally positive since there exist the dissimilar anatomical structures with the same image. In this work, we present a novel Contrastive Voxel-wise Representation Learning (CVRL) method to effectively learn low-level and high-level features by capturing 3D spatial context and rich anatomical information along both the feature and the batch dimensions. Specifically, we first introduce a novel CL strategy to ensure feature diversity promotion among the 3D representation dimensions. We train the framework through bi-level contrastive optimization (i.e., low-level and high-level) on 3D images. Experiments on two benchmark datasets and different labeled settings demonstrate the superiority of our proposed framework. More importantly, we also prove that our method inherits the benefit of hardness-aware property from the standard CL approaches.

Nicha C. Dvornek, Pamela Ventola, James S. Duncan

We propose a method for estimating more reproducible functional networks that are more strongly associated with dynamic task activity by using recurrent neural networks with long short term memory (LSTMs). The LSTM model is trained in an unsupervised manner to learn to generate the functional magnetic resonance imaging (fMRI) time-series data in regions of interest. The learned functional networks can then be used for further analysis, e.g., correlation analysis to determine functional networks that are strongly associated with an fMRI task paradigm. We test our approach and compare to other methods for decomposing functional networks from fMRI activity on 2 related but separate datasets that employ a biological motion perception task. We demonstrate that the functional networks learned by the LSTM model are more strongly associated with the task activity and dynamics compared to other approaches. Furthermore, the patterns of network association are more closely replicated across subjects within the same dataset as well as across datasets. More reproducible functional networks are essential for better characterizing the neural correlates of a target task.

Nicha C. Dvornek, Xiaoxiao Li, Juntang Zhuang et al.

Heterogeneous presentation of a neurological disorder suggests potential differences in the underlying pathophysiological changes that occur in the brain. We propose to model heterogeneous patterns of functional network differences using a demographic-guided attention (DGA) mechanism for recurrent neural network models for prediction from functional magnetic resonance imaging (fMRI) time-series data. The context computed from the DGA head is used to help focus on the appropriate functional networks based on individual demographic information. We demonstrate improved classification on 3 subsets of the ABIDE I dataset used in published studies that have previously produced state-of-the-art results, evaluating performance under a leave-one-site-out cross-validation framework for better generalizeability to new data. Finally, we provide examples of interpreting functional network differences based on individual demographic variables.

Juntang Zhuang, Nicha C. Dvornek, Sekhar Tatikonda et al.

Neural ordinary differential equations (Neural ODEs) are a new family of deep-learning models with continuous depth. However, the numerical estimation of the gradient in the continuous case is not well solved: existing implementations of the adjoint method suffer from inaccuracy in reverse-time trajectory, while the naive method and the adaptive checkpoint adjoint method (ACA) have a memory cost that grows with integration time. In this project, based on the asynchronous leapfrog (ALF) solver, we propose the Memory-efficient ALF Integrator (MALI), which has a constant memory cost \textit{w.r.t} number of solver steps in integration similar to the adjoint method, and guarantees accuracy in reverse-time trajectory (hence accuracy in gradient estimation). We validate MALI in various tasks: on image recognition tasks, to our knowledge, MALI is the first to enable feasible training of a Neural ODE on ImageNet and outperform a well-tuned ResNet, while existing methods fail due to either heavy memory burden or inaccuracy; for time series modeling, MALI significantly outperforms the adjoint method; and for continuous generative models, MALI achieves new state-of-the-art performance. We provide a pypi package at \url{https://jzkay12.github.io/TorchDiffEqPack/}

Chenyu You, Junlin Yang, Julius Chapiro et al.

Deep neural networks have shown exceptional learning capability and generalizability in the source domain when massive labeled data is provided. However, the well-trained models often fail in the target domain due to the domain shift. Unsupervised domain adaptation aims to improve network performance when applying robust models trained on medical images from source domains to a new target domain. In this work, we present an approach based on the Wasserstein distance guided disentangled representation to achieve 3D multi-domain liver segmentation. Concretely, we embed images onto a shared content space capturing shared feature-level information across domains and domain-specific appearance spaces. The existing mutual information-based representation learning approaches often fail to capture complete representations in multi-domain medical imaging tasks. To mitigate these issues, we utilize Wasserstein distance to learn more complete representation, and introduces a content discriminator to further facilitate the representation disentanglement. Experiments demonstrate that our method outperforms the state-of-the-art on the multi-modality liver segmentation task.